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MoonDragon's Pregnancy Information
BREECH PRESENTATION
POSITIONS & OVERVIEW


For "Informational Use Only".
For more detailed information, contact your health care provider
about options that may be available for your specific situation.





  • Breech Description
  • Frequent Signs & Symptoms
  • Causes
  • Ectopic Pregnancy Risk Factors
  • Preventive Measures
  • Expected Outcome
  • Potential Complications
  • Conventional Medical Treatment
  • Medication
  • Activity Recommendations & Restrictions
  • Diet & Nutrition
  • Notify Your Midwife or Health Care Provider




  • BREECH DESCRIPTION

    At birth, most babies are born head first with face down. In a breech presentation, the fetal buttocks or feet lie nearest the birth canal and are the first part to emerge. Breech presentation occurs in 3 to 4 percent of all births. Types of breech presentations include:



  • Frank breech where the thighs are flexed on the abdomen and both legs are extended at the knee so that the feet are near the head.




  • Complete breech where the thighs are flexed on the abdomen and both legs are flexed at the knee.




  • Footling breech where one or both legs are extended below the level of the buttocks.




  • Knee breech where one or both knees are extended below the level of the buttocks.







  • FREQUENT SIGNS & SYMPTOMS

  • There are no visible signs.
  • The diagnosis can be determined by abdominal palpation or vaginal examination and confirmed by ultrasound.
  • Fetal heart sounds are heard high on the mother's abdomen, usually around the belly button region.


  • breech in utero





    CAUSES

  • Before 36 weeks, the fetus may move about from one position to the other. In the later weeks of pregnancy, these changes are more difficult. Usually the fetus spontaneously assumes the head down position, but in some instances the breech position occurs.





  • RISK FACTORS

  • Premature labor and delivery.
  • Multiple fetuses.
  • Uterine abnormalities.
  • Fetal congenital malformation.
  • Pelvic tumor (fibroids).





  • PREVENTIVE MEASURES

  • None known to prevent the original breech position.


  • For some, a slanted board exercise where the mother lies with feet raised higher than her head for several minutes a few times a day. This exercise may be used in the latter part of pregnancy to attempt to naturally entice the fetus to change position to head down. This will only work if the fetus has not engaged into the pelvis.


  • For some others, after the breech position is diagnosed, a technique called external cephalic version is performed, which attempts to rotate the fetus to the proper position.


  • external cephalic version





    EXPECTED OUTCOME

  • The decision about delivery will be made on an individual basis. For some, a cesarean birth is recommended for breech babies, while in certain conditions, a vaginal delivery may be recommended. Discuss it fully with your health care provider or midwife.


  • In most cases, you and your baby will suffer no complications because of the breech presentation.





  • POTENTIAL COMPLICATIONS

  • Birth injury.
  • Compression of the umbilical cord causing lack of oxygen to the fetus.
  • Prolapse of the umbilical cord. Usual treatment for this would be a cesarean delivery.


  • cord prolapse





    CONVENTIONAL MEDICAL MANAGEMENT

    Once the diagnosis of a breech presentation is made, be sure you are informed and understand the options and risks (both to you and to the fetus) involved for each type of delivery (cesarean or vaginal). You may need to shop around to find a midwife or health care provider that will offer the support and method of delivery you may be interested in having. Many conventional medical services only dictate a cesarean delivery for breech. However, more practitioners are getting trained to handle vaginal breech deliveries and are including this option in their maternity care. Both have their attributes and drawbacks. Whomever you decide upon (midwife or other health care provider), be sure they have experience in vaginal deliveries of breech presentations and are willing to work with you and your birth plans.

    AFTER DELIVERY:
    • Showering is fine; delay tub baths for 2 to 3 weeks.


    • Some degree of postpartum depression (crying jags and feelings of inadequacy) may occur which is normal after birth. However, some research has shown the quality of the birth experience and immediate bonding between mother and baby seems to play a significant factor in the level of "postpartum blues" that the woman may experience.


    • Wear an external pad for the vaginal bleeding (lochia discharge) that will occur for several weeks. Your first menstrual period may return in 6 to 8 weeks, but may be delayed for several months if the mother is fully breastfeeding her infant.





    MEDICATION

  • Prescription medication may be given for 2 to 7 days following the procedure.
  • You may use non-prescription medication, such as acetaminophen, for minor pain.





  • ACTIVITY RECOMMENDATIONS & RESTRICTIONS

  • You may resume sexual relations after 2 weeks (although for some, 4 to 6 weeks may be recommended).


  • Return to normal activity as soon as your health and well being permit. This will occur more quickly following a vaginal delivery than it will with a cesarean delivery.





  • DIET & NUTRITION

    No special diet is usually necessary. However, if you are breastfeeding, continue with the same calorie and nutritional intake that you were eating during your pregnancy. Be sure to drink plenty of fluids to maintain your milk supply. See our Nutrition Information for obtaining and maintaining a healthy diet.




    NOTIFY YOUR MIDWIFE OR HEALTH CARE PROVIDER

    If any of the following occurs prior to birth:
    • New symptoms develop.

    Any of the following occurs following the birth:
    • Pain, swelling, redness, drainage or bleeding increases in the surgical area (cesarean or large episiotomy prior to forceps delivery in a medical facility).


    • You develop signs of infection: headache, muscle aches, dizziness, or a general ill feeling and fever.


    • Bleeding soaks more than one pad in an hour.


    • The urge to urinate frequently persists longer than one month.


    • Vaginal discharge persists beyond one month.


    MyBreechBirth: Home Birth of a Footling Breech Baby
    Breech Birth: A Planned Homebirth of a Footling Breech with Midwife
    Sabastian's Breech Homebirth Story (with wonderful photos)
    The Website: "Heads Up! All About Breech Babies"
    Vaginal Breech Pictorial - Hospital without Pain Medication, Episiotomy & Forceps
    Breech Presentation & Acupuncture
    Heads Up!: All About Breech Babies
    MomCare: Breech Turning Techniques
    BabyCenter.com: Breech Birth
    GentleBirth.org: Midwife Archives - Prenatal Breech Issues
    BirthSpirit: Breech Birth Woman-Wise by Maggie Banks
    MoonDragon's Pregnancy Information: Breech Presentation Information
    MoonDragon's Pregnancy Information: Breech Turning Ideas
    MoonDragon's Pregnancy Information: Performing External Cephalic Version
    MoonDragon's Pregnancy Information: Breech Labor - What to Expect
    MoonDragon's Pregnancy Information: Breech Labor - Esstablished Breech
    MoonDragon's Pregnancy Information: Breech Labor - How the Attendant May Assist
    MoonDragon's Pregnancy Information: The Breech Delivery at Home
    MoonDragon's Pregnancy Information: Vaginal Breech Pictorial - Hospital with Episiotomy & Forceps
    MoonDragon's Birthing Guidelines - The Unexpected Breech
    MoonDragon's Pregnancy Information: Pregnancy Information & Survival Tips
    MoonDragon's Pregnancy Index
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